The Dreaded Pill Count

If you have been a follower of my writing, you know my stance on narcs.  I believe 90% of the chronic pain people are bullsh%t.   You can read entry after entry where  I have blogged evidence to prove that.   I also think most docs who dabble in chronic pain management are idiots.   I just heard of one who does the “Suboxone” thing and even when his patients are found to be selling it, he still won’t fire them.  He feels that is some small way he is “treating” others, who he doesn’t know, of their problem.  Moron.  Anyway, for those who don’t think narc seekers really exist, this link gives a little taste of how they work on problems together.  Enjoy the thread called Oxycontin and the Dreaded Pill Count.  Sounds like a children’s book, doesn’t it?

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  6 comments for “The Dreaded Pill Count

  1. Princess of Problem Patients
    March 11, 2013 at 10:49 am

    Wow. I’ve never gone to a pain clinic but it bothers me that some doctors are enablers. It doesn’t surprise me, but it does bother me. I’ve had chronic pain issues for years from endometriosis and fibromyalgia (not a musculoskeletal disorder but a f’d up cns disorder), and didn’t really notice that much extra pain when I was undergoing treatment for breast cancer. The last time I took real narcotics was after a laparoscopic myomectomy, and although they worked, they made me nauseated. I’m on tramadol but have to take the 50 mg pills because all of the extended release dosages make me nauseated. Thank goodness there’s a segment of the population that opiates don’t agree with? :-/

  2. Sir Lance-a-Lot
    March 6, 2013 at 11:20 am

    My view of this, which I am always happy to share (ad nauseum, in all likelihood), is that I am a doctor and not a cop, and it is not my job to enforce a bunch of drug laws with which I disagree.

    I believe that all of this stuff should be over-the-counter (with a signature required, like Sudafed).
    If you want to abuse narcs, go ahead. You’re going to “buy it on the street” anyway (as patients regularly remind me when I refuse to give them Rx’s). Although most people would use these drugs sparingly if at all, there is a proportion of the population that is going to do everything they can to get wasted, and will never have a productive job, no matter what we do.
    Let ’em get high, and maybe kill themselves, for a low over-the-counter price, and maybe fewer of us will have our ipods and car stereos stolen.

    Meanwhile, I will assume that EVERY patient I see is trying to scam me for drugs (either Benzos, opiates, or antibiotics) until proven otherwise.

  3. Dr Phil
    March 4, 2013 at 6:48 am

    I can’t post to their website without “donating” some money…. My answer to the girl, would be to kick up a stink that the doctor is over-servicing her, that all they want is her insurance/Medicare money by making her come in more frequently. I wonder which side the bureaucrats will support?

  4. PainDoc
    March 2, 2013 at 3:32 pm

    It’s on Opiophile, go figure. A great site to find out what your drug seeking patients are going to try to scam you

  5. CancerDoc
    March 2, 2013 at 10:24 am

    I would like to write that I do believe there is a definite roll of opiates in pain control. However, there is a huge risk of abuse. I would like to believe that all of my patients are honest with me about their pain and their use of their drugs, but that isn’t true. Realizing the lie creates a difficult problem.

    As our country grapples with how to deal with guns and violence, there seems to be less thought to how the over-treatment of pain is leading to significant morbidity AND mortality.

  6. CancerDoc
    March 2, 2013 at 10:10 am

    I did not need to see that.

    As a medical oncologist, I prescribe a lot of opiates. Unfortunately, I am very aware of the risk of diversion and have, despite a slightly laxer system than pain medicine clinics caught a handful of patients in blatant diversion. From my side of the stethoscope, it is extremely painful to have to tell a patient that has cancer (and likely has pain) that I will not prescribe their drugs because there is no way that they should be getting 1000 Lortab 10’s a month (that case occurred with 4 different physicians prescribing with the patient taking the prescriptions to different pharmacies, but having them all filled on his insurance (head slap). The insurance company alerted the various prescribing parties AFTER FOUR MONTHS).

    One thing not on that disgusting thread that you linked: Do NOT tell your doctor/pharmacist that your dog ate the bottle. (In my part of the country, that seems to be the story of choice). My fellow colleagues have told me that they find it very difficult not to LOL in front of you — and we hear that is not professional. If your dog eats the entire bottle of dilauded, I want to see the dead dog. (In reality, I have gotten very good at hiding my LOL’s….I can ask with a straight face, “how is your dog?” It’s amazing how these dogs can eat entire bottles without any ill effect AT ALL. I usually keep the story rolling by suggesting that they might watch for constipation…..).

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